Carnitine

A 1996 review of clinical studies concluded that no scientific basis exists for the belief that carnitine supplements enhance athletic performance.¹¹⁶ A few studies have found some benefit, but most have not.

Safety Issues

L-carnitine in its three forms appears to be quite safe. However, individuals with low or borderline-low thyroid levels should avoid carnitine because it might impair the action of thyroid hormone.¹¹⁷

Individuals on dialysis should not receive this (or any other supplement) without a physician's supervision.

The maximum safe dosages for young children, pregnant or nursing women, or those with severe liver or kidney disease have not been established.

Interactions You Should Know About

If you are taking

Antiseizure medications, particularly valproic acid (Depakote, Depakene) but also phenytoin (Dilantin): You may need extra carnitine.
Thyroid medication: Do not take carnitine except under a physician's supervision.

References

1. Hug C, McGraw CA, Bates SR, et al. Reduction of serum carnitine concentrations during anticonvulsant therapy with phenobarbital, valproic acid, phenytoin, and carbamazepine in children. J Pediatr. 1991;119:799-802.

2. Chung S, Choi J, Hyun T, et al. Alterations in the carnitine metabolism in epileptic children treated with valproic acid. J Korean Med Sci. 1997;12:553-558.

3. Melegh B, Trombitas K. Valproate treatment induces lipid globule accumulation with ultrastructual abnormalities of mitochondria in skeletal muscle. Neuropediatrics. 1997;28:257-261.

4. Zelnik N, Fridkis I, Gruener N. Reduced carnitine and antiepileptic drugs: cause relationship or co-existence? Acta Paediatr. 1995;84:93-95.

5. Coulter DL. Carnitine deficiency in epilepsy: risk factors and treatment. J Child Neurol. 1995;10(suppl 2):S32-S39.

6. Melegh B, Pap M, Morava E, et al. Carnitine-dependent changes of metabolic fuel consumption during long-term treatment with valproic acid. J Pediatr. 1994;125:317-321.

7. De Vivo DC, Bohan TP, Coulter DL, et al. L-carnitine supplementation in childhood epilepsy: current perspectives. Epilepsia. 1998;13:1216-1225.

8. Matsuda I, Ohtani Y. Carnitine status in Reye and Reye-like syndromes. Pediatr Neurol. 1986;2:90-94.

9. Camina MF, Rozas I, Gomez M, et al. Short-term effects of administration of anticonvulsant drugs on free carnitine and acylcarnitine in mouse serum and tissues. Br J Pharmacol. 1991;103:1179-1183.

10. Rodriguez-Segade S, de la Pena CA, Tutor JC, et al. Carnitine deficiency associated with anticonvulsant therapy. Clin Chim Acta. 1989;181:175-181.

11. Ater SB. A developmental center population treated with VPA and L-carnitine. In: Update 1993: inborn errors of metabolism in the patient with epilepsy. Sigma-Tau Pharmaceuticals; 1993.

12. Cacciatore L, Cerio R, Ciarimboli M, et al. The therapeutic effect of L-carnitine in patients with exercise-induced stable angina: a controlled study. Drugs Exp Clin Res. 1991;17:225-235.

13. Bartels GL, Remme WJ, Pillay M, et al. Effects of L-propionylcarnitine on ischemia-induced myocardial dysfunction in men with angina pectoris. Am J Cardiol. 1994;74:125-130.

14. Bartels GL, Remme WJ, den Hartog FR, et al. Additional anti-ischemic effects of long-term L-propionylcarnitine in anginal patients treated with conventional antianginal therapy. Cardiovasc Drugs Ther. 1995;9:749-753.

15. Bartels GL, Remme WJ, Holwerda KJ, et al. Anti-ischaemic efficacy of L-propionyl-carnitinea promising novel metabolic approach to ischaemia? Eur Heart J. 1996;17:414-420.

16. Cherchi A, Lai C, Angelino F, et al. Effects of L-carnitine on exercise tolerance in chronic stable angina: a multicenter, double-blind, randomized, placebo controlled crossover study. Int J Clin Pharmacol Ther Toxicol. 1985;23:569-572.

17. Lagioia R, Scrutinio D, Mangini SG, et al. Propionyl-L-carnitine: a new compound in the metabolic approach to the treatment of effort angina. Int J Cardiol. 1992;34:167-172.

18. Davini P, Bigalli A, Lamanna F, et al. Controlled study on L-carnitine therapeutic efficacy in post-infarction. Drugs Exp Clin Res. 1992;18:355-365.

19. Iliceto S, Scrutinio D, Bruzzi P, et al. Effect of L-carnitine administration on left ventricular remodeling after acute anterior myocardial infarction: the L-Carnitine Ecocardiografia Digitalizzata Infarto Miocardico (CEDIM) Trial. J Am Coll Cardiol. 1995;26:380-387.

20. Brevetti G, Perna S, Sabba C, et al. Propionyl-L-carnitine in intermittent claudication: Double-blind, placebo-controlled, dose titration, multicenter study. J Am Coll Cardiol. 1995;26:1411-1416.

21. Bolognesi M, Amodio P, Merkel C, et al. Effect of 8-day therapy with propionyl-L-carnitine on muscular and subcutaneous blood flow of the lower limbs in patients with peripheral arterial disease. Clin Physiol. 1995;15:417-423.

22. Brevetti G, Perna S, Sabba C, et al. Superiority of L-propionylcarnitine vs L-carnitine in improving walking capacity in patients with peripheral vascular disease: an acute, intravenous, double-blind, cross-over study. Eur Heart J. 1992;13:251-255.

23. Greco AV, Mingrone G, Bianchi M, et al. Effect of propionyl-L-carnitine in the treatment of diabetic angiopathy: Controlled double blind trial versus placebo. Drugs Exp Clin Res. 1992;18:69-80.

24. Brevetti G, Chiariello M, Ferulano G, et al. Increases in walking distance in patients with peripheral vascular disease treated with L-carnitine: a double-blind, cross-over study. Circulation. 1988;77:767-773.

25. Deckert J. Propionyl-L-carnitine for intermittent claudication. J Fam Pract. 1997;44:533-534.

26. Sabba C, Berardi E, Antonica G, et al. Comparison between the effect of L-propionylcarnitine, L-acetylcarnitine and nitroglycerin in chronic peripheral arterial disease: a haemodynamic double blind echo-Doppler study. Eur Heart J. 1994;15:1348-1352.

27. Pepine CJ. The therapeutic potential of carnitine in cardiovascular disorders. Clin Ther. 1991;13:2-21.

28. Brevetti G, Attisano T, Perna S, et al. Effect of L-carnitine on the reactive hyperemia in patients affected by peripheral vascular disease: a double-blind, crossover study. Angiology. 1989;40:857-862.

29. Brevetti G, Diehm C, Lambert D. European multicenter study on propionyl-L-carnitine in intermittent claudication. J Am Coll Cardiol. 1999;34:1618-1624.

30. Hiatt WR, Regensteiner JG, Creager MA, et al. Propionyl-L-carnitine improves exercise performance and functional status in patients with claudication. Am J Med. 2001;110:616-622.

31. Caponnetto S, Canale C, Masperone MA, et al. Efficacy of L-propionylcarnitine treatment in patients with left ventricular dysfunction. Eur Heart J. 1994;15:1267-1273.

32. Mancini M, Rengo F, Lingetti M, et al. Controlled study on the therapeutic efficacy of propionyl-L-carnitine in patients with congestive heart failure. Arzneimittelforschung. 1992;42:1101-1104.

33. Pucciarelli G, Mastursi M, Latte S, et al. The clinical and hemodynamic effects of propionyl-L-carnitine in the treatment of congestive heart failure [in Italian; English abstract]. Clin Ter. 1992;141:379-384.

34. Cacciatore L, Cerio R, Ciarimboli M, et al. The therapeutic effect of L-carnitine in patients with exercise-induced stable angina: a controlled study. Drugs Exp Clin Res. 1991;17:225-235.

35. Winter S, Jue K, Prochazka J, et al. The role of L-carnitine in pediatric cardiomyopathy. J Child Neurol. 1995;10(suppl 2):S45-S51.

36. Pepine CJ. The therapeutic potential of carnitine in cardiovascular disorders. Clin Ther. 1991;13:2-21.

37. Dal Negro R, Pomari G, Zoccatelli O, et al. L-carnitine and rehabilitative respiratory physiokinesitherapy: metabolic and ventilatory response in chronic respiratory insufficiency. Int J Clin Pharmacol. 1986;24:453-456.

38. Dal Negro R, Turco P, Pomari C, et al. Effects of L-carnitine on physical performance in chronic respiratory insufficiency. Int J Clin Pharmacol. 1988;26:269-272.

39. Dal Negro R, Zoccatelli D, Pomari C, et al. L-carnitine and physiokinesiotherapy in chronic respiratory insufficiency. Preliminary results. Clin Trials J. 1985;22:353-360.

40. Passeri M, Cucinotta D, Bonati PA, et al. Acetyl-L-carnitine in the treatment of mildly demented elderly patients. Int J Clin Pharmacol Res. 1990;10:75-79.

41. Calvani M, Carta A, Caruso G, et al. Action of acetyl-L-carnitine in neurodegeneration and Alzheimer's disease. Ann N Y Acad Sci. 1992;663:483-486.

42. Sano M, Bell K, Cote L, et al. Double-blind parallel design pilot study of acetyl levocarnitine in patients with Alzheimer's disease. Arch Neurol. 1992;49:1137-1141.

43. Spagnoli A, Lucca U, Menasce G, et al. Long-term acetyl-L-carnitine treatment in Alzheimer's disease. Neurology. 1991;41:1726-1732.

44. Campi N, Todeschini GP, Scarzella L. Selegiline versus L-acetylcarnitine in the treatment of Alzheimer-type dementia. Clin Ther. 1990;12:306-314.

45. Vecchi GP, Chiari G, Cipolli C, et al. Acetyl-l-carnitine treatment of mental impairment in the elderly: evidence from a multicenter study. Arch Gerontol Geriatr. 1991;(suppl 2):159-168.

46. Bonavita E. Study of the efficacy and tolerability of L-acetylcarnitine therapy in the senile brain. Int J Clin Pharmacol Ther Toxicol. 1986;24:511-516.

47. Thal LJ, Carta A, Clarke WR, et al. A 1-year multicenter placebo-controlled study of acetyl-L-carnitine in patients with Alzheimer's disease. Neurology. 1996;47:705-711.

48. Thal LJ, Calvani M, Amato A, et al. A 1-year controlled trial of acetyl-l-carnitine in early-onset AD. Neurology. 2000;55:805-810.

49. Bella R, Biondi R, Raffaele R, et al. Effect of acetyl-L-carnitine on geriatric patients suffering from dysthymic disorders. Int J Clin Pharmacol Res. 1990;10:355-360.

50. Garzya G, Corallo D, Fiore A, et al. Evaluation of the effects of L-acetylcarnitine on senile patients suffering from depression. Drugs Exp Clin Res. 1990;16:101-106.

51. Torrioli MG, Vernacotola S, Mariotti P, et al. Double-blind, placebo-controlled study of L-acetylcarnitine for the treatment of hyperactive behavior in fragile X syndrome. Am J Med Genet. 1999;87:366-368.

52. Mingrone G, Greco AV, Capristo E, et al. L-carnitine improves glucose disposal in type 2 diabetic patients. J Am Coll Nutr. 1999;18:77-82.

53. Turpeinen AK, Kuikka JT, Vanninen E, et al. Long-term effect of acetyl-L-carnitine on myocardial 123I-MIBG uptake in patients with diabetes. Clin Auton Res. 2000;10:13-16.

54. Davini P, Bigalli A, Lamanna F, et al. Controlled study on L-carnitine therapeutic efficacy in post-infarction. Drugs Exp Clin Res. 1992;18:355-365.

55. Sorbi S, Forleo P, Fani C, et al. Double-blind, crossover, placebo-controlled clinical trial with L-acetylcarnitine in patients with degenerative cerebellar ataxia. Clin Neuropharmacol. 2000;23:114-118.

56. Plioplys AV, Plioplys S. Amantadine and L-carnitine treatment of chronic fatigue syndrome. Neuropsychobiology. 1997;35:16-23.

57. Benvenga S, Ruggeri RM, Russo A, et al. Usefulness of l-carnitine, a naturally occurring peripheral antagonist of thyroid hormone action, in iatrogenic hyperthyroidism: a randomized, double-blind, placebo-controlled clinical trial. J Clin Endocrinol Metab. 2001;86:3579-3594.

58. Loumbakis P, Anezinis P, Evangeliou A, et al. Effect of L-carnitine in patients with asthenospermia [abstract]. Eur Urol. 1996;30(suppl 2):255.

59. Muller-Tyl E, Lohninger A, Fischl F, et al. The effect of carnitine on sperm count and sperm motility [translated from German]. Fertilitat. 1988;4:1-4.

60. Micic S, Lalic N, Nale DJ, et al. Effects of L-carnitine on sperm motility and number in infertile men [abstract]. Fertil Steril. 1998;70(3 suppl 1):S12.

61. Vicari E. Effectiveness of a short-term anti-oxidative high-dose therapy on IVF program outcome in infertile male patients with previous excessive sperm Radical Oxygen Species production persistent even following antimicrobials administered for epididymitis: preliminary results. In: International Meeting on Infertility and Assisted Reproductive Technology, Porto Cervo, Italy, June 11-14, 1997. Bologna, Italy: Monduzzi Editore SpA; 1997.

62. Vicari E, Cerri L, Cataldo T, et al. Effectiveness of single and combined antioxidant therapy in patients with astheno-necrozoospermia from non-bacterial epididymitis: effects after acetyl-carnitine or carnitine-acetyl-carnitine. Presented at: 12th National Conference, Italian Andrology Association; June 9-12, 1999; Copanello (CZ), Italy.

63. Campaniello E, Petrarolo N, Meriggiola MC, et al. Carnitine administration in asthenospermia. Presented at: 4th International Congress of Andrology; May 14-18, 1989; Florence, Italy.

64. Costa M, Canale D, Filicori M, et al. L-carnitine in idiopathic asthenozoospermia: a multicenter study. Andrologia. 1994;26:155-159.

65. Vitali G, Parente R, Melotti C. Carnitine supplementation in human idiopathic asthenospermia: clinical results. Drugs Exp Clin Res. 1995;21:157-159.

66. Moncada ML, Vicari E, Cimino C, et al. Effect of acetylcarnitine treatment in oligoasthenospermic patients. Acta Eur Fertil. 1992;23:221-224.

67. Semino-Mora MC, Leon-Monzon ME, Dalakas MC. Effect of L-carnitine on the zidovudine-induced destruction of human myotubes. Part I: L-carnitine prevents the myotoxicity of AZT in vitro. Lab Invest. 1994;71:102-112.

68. Dalakas MC, Leon-Monzon ME, Bernardini I, et al. Zidovudine-induced mitochondrial myopathy is associated with muscle carnitine deficiency and lipid storage. Ann Neurol. 1994;35:482-487.

69. Heinonen OJ. Carnitine and physical exercise. Sports Med. 1996;22:109-132.

70. Cacciatore L, Cerio R, Ciarimboli M, et al. The therapeutic effect of L-carnitine in patients with exercise-induced stable angina: a controlled study. Drugs Exp Clin Res. 1991;17:225-235.

71. Cherchi A, Lai C, Angelino F, et al. Effects of L-carnitine on exercise tolerance in chronic stable angina: a multicenter, double-blind, randomized, placebo controlled crossover study. Int J Clin Pharmacol Ther Toxicol. 1985;23:569-572.

72. Bartels GL, Remme WJ, Pillay M, et al. Effects of L-propionylcarnitine on ischemia-induced myocardial dysfunction in men with angina pectoris. Am J Cardiol. 1994;74:125-130.

73. Bartels GL, Remme WJ, den Hartog FR, et al. Additional anti-ischemic effects of long-term L-propionylcarnitine in anginal patients treated with conventional antianginal therapy. Cardiovasc Drugs Ther. 1995;9:749-753.

74. Bartels GL, Remme WJ, Holwerda KJ, et al. Anti-ischaemic efficacy of L-propionyl-carnitinea promising novel metabolic approach to ischaemia? Eur Heart J. 1996;17:414-420.

75. Lagioia R, Scrutinio D, Mangini SG, et al. Propionyl-L-carnitine: a new compound in the metabolic approach to the treatment of effort angina. Int J Cardiol. 1992;34:167-172.

76. Sabba C, Berardi E, Antonica G, et al. Comparison between the effect of L-propionylcarnitine, L-acetylcarnitine and nitroglycerin in chronic peripheral arterial disease: a haemodynamic double blind echo-Doppler study. Eur Heart J. 1994;15:1348-1352.

77. Brevetti G, Diehm C, Lambert D. European multicenter study on propionyl-L-carnitine in intermittent claudication. J Am Coll Cardiol. 1999;34:1618-1624.

78. Brevetti G, Perna S, Sabba C, et al. Propionyl-L-carnitine in intermittent claudication: Double-blind, placebo-controlled, dose titration, multicenter study. J Am Coll Cardiol. 1995;26:1411-1416.

79. Bolognesi M, Amodio P, Merkel C, et al. Effect of 8-day therapy with propionyl-L-carnitine on muscular and subcutaneous blood flow of the lower limbs in patients with peripheral arterial disease. Clin Physiol. 1995;15:417-423.

80. Brevetti G, Perna S, Sabba C, et al. Superiority of L-propionylcarnitine vs L-carnitine in improving walking capacity in patients with peripheral vascular disease: an acute, intravenous, double-blind, cross-over study. Eur Heart J. 1992;13:251-255.

81. Greco AV, Mingrone G, Bianchi M, et al. Effect of propionyl-L-carnitine in the treatment of diabetic angiopathy: Controlled double blind trial versus placebo. Drugs Exp Clin Res. 1992;18:69-80.

82. Brevetti G, Chiariello M, Ferulano G, et al. Increases in walking distance in patients with peripheral vascular disease treated with L-carnitine: a double-blind, cross-over study. Circulation. 1988;77:767-773.

83. Deckert J. Propionyl-L-carnitine for intermittent claudication. J Fam Pract. 1997;44:533-534.

84. Sabba C, Berardi E, Antonica G, et al. Comparison between the effect of L-propionylcarnitine, L-acetylcarnitine and nitroglycerin in chronic peripheral arterial disease: a haemodynamic double blind echo-Doppler study. Eur Heart J. 1994;15:1348-1352.

85. Pepine CJ. The therapeutic potential of carnitine in cardiovascular disorders. Clin Ther. 1991;13:2-21.

86. Brevetti G, Attisano T, Perna S, et al. Effect of L-carnitine on the reactive hyperemia in patients affected by peripheral vascular disease: a double-blind, crossover study. Angiology. 1989;40:857-862.

87. Hiatt WR, Regensteiner JG, Creager MA, et al. Propionyl-L-carnitine improves exercise performance and functional status in patients with claudication. Am J Med. 2001;110:616-622.

88. Caponnetto S, Canale C, Masperone MA, et al. Efficacy of L-propionylcarnitine treatment in patients with left ventricular dysfunction. Eur Heart J. 1994;15:1267-1273.

89. Mancini M, Rengo F, Lingetti M, et al. Controlled study on the therapeutic efficacy of propionyl-L-carnitine in patients with congestive heart failure. Arzneimittelforschung. 1992;42:1101-1104.

90. Pucciarelli G, Mastursi M, Latte S, et al. The clinical and hemodynamic effects of propionyl-L-carnitine in the treatment of congestive heart failure [in Italian; English abstract]. Clin Ter. 1992;141:379-384.

91. Cacciatore L, Cerio R, Ciarimboli M, et al. The therapeutic effect of L-carnitine in patients with exercise-induced stable angina: a controlled study. Drugs Exp Clin Res. 1991;17:225-235.

92. Loster H, Miehe K, Punzel M, et al. Prolonged oral L-carnitine substitution increases bicycle ergometer performance in patients with severe, ischemically induced cardiac insufficiency. Cardiovasc Drugs Ther. 1999;13:537-546.

93. Davini P, Bigalli A, Lamanna F, et al. Controlled study on L-carnitine therapeutic efficacy in post-infarction. Drugs Exp Clin Res. 1992;18:355-365.

94. Iliceto S, Scrutinio D, Bruzzi P, et al. Effect of L-carnitine administration on left ventricular remodeling after acute anterior myocardial infarction: the L-Carnitine Ecocardiografia Digitalizzata Infarto Miocardico (CEDIM) Trial. J Am Coll Cardiol. 1995;26:380-387.

95. Dal Negro R, Pomari G, Zoccatelli O, et al. L-carnitine and rehabilitative respiratory physiokinesitherapy: metabolic and ventilatory response in chronic respiratory insufficiency. Int J Clin Pharmacol. 1986;24:453-456.

96. Dal Negro R, Turco P, Pomari C, et al. Effects of L-carnitine on physical performance in chronic respiratory insufficiency. Int J Clin Pharmacol. 1988;26:269-272.

97. Dal Negro R, Zoccatelli D, Pomari C, et al. L-carnitine and physiokinesiotherapy in chronic respiratory insufficiency. Preliminary results. Clin Trials J. 1985;22:353-360.

98. Calvani M, Carta A, Caruso G, et al. Action of acetyl-L-carnitine in neurodegeneration and Alzheimer's disease. Ann N Y Acad Sci. 1992;663:483-486.

99. Cipolli C, Chiari G. Effects of L-acetylcarnitine on mental deterioration in the aged: initial results [in Italian; English abstract]. Clin Ter. 1990;132(6 suppl):479-510.

100. Passeri M, Cucinotta D, Bonati PA, et al. Acetyl-L-carnitine in the treatment of mildly demented elderly patients. Int J Clin Pharmacol Res. 1990;10:75-79.

101. Salvioli G, Neri M. L-acetylcarnitine treatment of mental decline in the elderly. Drugs Exp Clin Res. 1994;20:169-176.

102. Spagnoli A, Lucca U, Menasce G, et al. Long-term acetyl-L-carnitine treatment in Alzheimer's disease. Neurology. 1991;41:1726-1732.

103. Vecchi GP, Chiari G, Cipolli C, et al. Acetyl-l-carnitine treatment of mental impairment in the elderly: evidence from a multicenter study. Arch Gerontol Geriatr. 1991;(suppl 2):159-168.

104. Thal LJ, Carta A, Clarke WR, et al. A 1-year multicenter placebo-controlled study of acetyl-L-carnitine in patients with Alzheimer's disease. Neurology. 1996;47:705-711.

105. Campi N, Todeschini GP, Scarzella L. Selegiline versus L-acetylcarnitine in the treatment of Alzheimer-type dementia. Clin Ther. 1990;12:306-314.

106. Sano M, Bell K, Cote L, et al. Double-blind parallel design pilot study of acetyl levocarnitine in patients with Alzheimer's disease. Arch Neurol. 1992;49:1137-1141.

107. Rai G, Wright G, Scott L, et al. Double-blind, placebo controlled study of acetyl-l-carnitine in patients with Alzheimer's dementia. Curr Med Res Opin. 1990;11:638-647.

108. Bonavita E. Study of the efficacy and tolerability of L-acetylcarnitine therapy in the senile brain. Int J Clin Pharmacol Ther Toxicol. 1986;24:511-516.

109. Thal LJ, Calvani M, Amato A, et al. A 1-year controlled trial of acetyl-l-carnitine in early-onset AD. Neurology. 2000;55:805-810.

110. Thal LJ, Carta A, Clarke WR, et al. A 1-year multicenter placebo-controlled study of acetyl-L-carnitine in patients with Alzheimer's disease. Neurology. 1996;47:705-711.

111. Thal LJ, Calvani M, Amato A, et al. A 1-year controlled trial of acetyl-l-carnitine in early-onset AD. Neurology. 2000;55:805-810.

112. Bella R, Biondi R, Raffaele R, et al. Effect of acetyl-L-carnitine on geriatric patients suffering from dysthymic disorders. Int J Clin Pharmacol Res. 1990;10:355-360.

113. Garzya G, Corallo D, Fiore A, et al. Evaluation of the effects of L-acetylcarnitine on senile patients suffering from depression. Drugs Exp Clin Res. 1990;16:101-106.

114. Benvenga S, Ruggeri RM, Russo A, et al. Usefulness of l-carnitine, a naturally occurring peripheral antagonist of thyroid hormone action, in iatrogenic hyperthyroidism: a randomized, double-blind, placebo-controlled clinical trial. J Clin Endocrinol Metab. 2001;86:3579-3594.

115. Benvenga S, Lakshmanan M, Trimarchi F. Carnitine is a naturally occurring inhibitor of thyroid hormone nuclear uptake. Thyroid. 2000;10:1043-1050.

116. Heinonen OJ. Carnitine and physical exercise. Sports Med. 1996;22:109-132.

117. Benvenga S, Lakshmanan M, Trimarchi F. Carnitine is a naturally occurring inhibitor of thyroid hormone nuclear uptake. Thyroid. 2000;10:1043-1050.

118. Biagiotti G, Cavallini G. Acetyl-L-carnitine vs tamoxifen in the oral therapy of Peyronie's disease: a preliminary report. BJU Int. 2001;88:63-67.